Acute effects of mirtazapine on sleep continuity and sleep architecture indepressed patients: A pilot study

Background: Mirtazapine, a clinically effective antidepressant, acts by ant agonizing central alpha(2)-adrenergic and 5-HT2/5-HT3 receptors, No data ar e available regarding mirtazapine's effects on sleep architecture in patien ts with major depressive disorder: Methods: Six patients meeting criteria for major depressive disorder and sc oring greater than or equal to 4 on the three Hamilton Depression Raring Sc ale sleep items were studied Polysomnographic evaluations were performed at baseline and after I (15 mg at bedtime) and 2 weeks (30 mg at bedtime) of open-label mirtazapine treatment. Results: Mirtazapine significantly decreased sleep latency and significantl y increased total sleep rime and sleep efficiency from baseline levels duri ng week I, with similar results observed after week 2. Mirtazapine did not significantly alter rapid eye movement sleep parameters. Clinically, Hamilt on Depression Rating Scale and sleep disturbance ratings improved after tre atment. Conclusions: Mirtazapine significantly improves sleep continuity in major d epressive disorder patients with poor sleep quality at weeks I and 2 of tre atment, while preserving sleep architecture. (C) 2000 Society of Biological Psychiatry.